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Endothelial dysfunction in COVID-19: a position paper of the ESC Working Group for Atherosclerosis and Vascular Biology, and the ESC Council of Basic Cardiovascular Science

Cardiovascular Research, 2020-12, Vol.116 (14), p.2177-2184 [Peer Reviewed Journal]

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. 2020 ;Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. ;2020. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at https://academic.oup.com/journals/pages/coronavirus . ;Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions please email: journals.permissions@oup.com. 2020 ;ISSN: 0008-6363 ;ISSN: 1755-3245 ;EISSN: 1755-3245 ;DOI: 10.1093/cvr/cvaa230 ;PMID: 32750108

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Title:
Endothelial dysfunction in COVID-19: a position paper of the ESC Working Group for Atherosclerosis and Vascular Biology, and the ESC Council of Basic Cardiovascular Science
Author: Evans, Paul C ; Rainger, G Ed ; Mason, Justin C ; Guzik, Tomasz J ; Osto, Elena ; Stamataki, Zania ; Neil, Desley ; Hoefer, Imo E ; Fragiadaki, Maria ; Waltenberger, Johannes ; Weber, Christian ; Bochaton-Piallat, Marie-Luce ; Bäck, Magnus
Subjects: Angiotensin-Converting Enzyme 2 - metabolism ; Cardiovascular Agents - therapeutic use ; Cardiovascular Diseases - drug therapy ; Cardiovascular Diseases - metabolism ; Cardiovascular Diseases - physiopathology ; Cardiovascular Diseases - virology ; COVID-19 - drug therapy ; COVID-19 - metabolism ; COVID-19 - physiopathology ; COVID-19 - virology ; Cytokines - metabolism ; Endothelium, Vascular - drug effects ; Endothelium, Vascular - metabolism ; Endothelium, Vascular - physiopathology ; Endothelium, Vascular - virology ; Host-Pathogen Interactions ; Humans ; Inflammation Mediators - metabolism ; Medicin och hälsovetenskap ; Prognosis ; Review ; Risk Assessment ; Risk Factors ; SARS-CoV-2 - drug effects ; SARS-CoV-2 - metabolism ; SARS-CoV-2 - pathogenicity ; Virus Internalization
Is Part Of: Cardiovascular Research, 2020-12, Vol.116 (14), p.2177-2184
Description: Abstract The COVID-19 pandemic is an unprecedented healthcare emergency causing mortality and illness across the world. Although primarily affecting the lungs, the SARS-CoV-2 virus also affects the cardiovascular system. In addition to cardiac effects, e.g. myocarditis, arrhythmias, and myocardial damage, the vasculature is affected in COVID-19, both directly by the SARS-CoV-2 virus, and indirectly as a result of a systemic inflammatory cytokine storm. This includes the role of the vascular endothelium in the recruitment of inflammatory leucocytes where they contribute to tissue damage and cytokine release, which are key drivers of acute respiratory distress syndrome (ARDS), in disseminated intravascular coagulation, and cardiovascular complications in COVID-19. There is also evidence linking endothelial cells (ECs) to SARS-CoV-2 infection including: (i) the expression and function of its receptor angiotensin-converting enzyme 2 (ACE2) in the vasculature; (ii) the prevalence of a Kawasaki disease-like syndrome (vasculitis) in COVID-19; and (iii) evidence of EC infection with SARS-CoV-2 in patients with fatal COVID-19. Here, the Working Group on Atherosclerosis and Vascular Biology together with the Council of Basic Cardiovascular Science of the European Society of Cardiology provide a Position Statement on the importance of the endothelium in the underlying pathophysiology behind the clinical presentation in COVID-19 and identify key questions for future research to address. We propose that endothelial biomarkers and tests of function (e.g. flow-mediated dilatation) should be evaluated for their usefulness in the risk stratification of COVID-19 patients. A better understanding of the effects of SARS-CoV-2 on endothelial biology in both the micro- and macrovasculature is required, and endothelial function testing should be considered in the follow-up of convalescent COVID-19 patients for early detection of long-term cardiovascular complications.
Publisher: England: Oxford University Press
Language: English
Identifier: ISSN: 0008-6363
ISSN: 1755-3245
EISSN: 1755-3245
DOI: 10.1093/cvr/cvaa230
PMID: 32750108
Source: Coronavirus Research Database

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Endothelial dysfunction in COVID-19: a position paper of the ESC Working Group for Atherosclerosis and Vascular Biology, and the ESC Council of Basic Cardiovascular Science

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